Role Development: Advanced Nursing

Masters prepared nurse researchers identify research questions, design and conduct scientific studies, collect and analyze data, and report their findings, producing results that improve patient outcomes and quality of life. (“Reseacher,” 2012). Master prepared nurses have a distinct advantage in drawing from their own very varied experiences as staff nurses.

The Master’s prepared nurse as collaborator implements and enhances best practices through collaboration with peers, students, administrators, and communities of interest. The collaborator consults with others within and outside nursing.

The collaborator communicates to ensure best practices in nursing and education. On a daily basis the APN is collaborating with physicians about her patients and their treatment. She then collaborates with the staff nurse as to the course of treatment, finally collaborating with the patient as to the treatment plan and what is expected from the patient. Often times many disciplines are involve in the patients care and the MSN collaborates with all about their specific role in treating the patient.

CLINICIAN

The Master’s prepared nurse as clinician received additional nursing training in the MSN program that allows her to evaluate and treat patients, performing many of the tasks normally handled by physicians. The nurse clinician is competent and proficient and provides safe, quality patient care.

The clinician often leads an interdisciplinary team communicating, planning, and implementing care directly with physicians or APRNs, case workers, pharmacy, dietary and other nurses. The clinician evaluates patient outcomes, assesses risks, and has the decision-making authority to change care plans when necessary. (“Clinical,” n.d)

CONSUMER ADVOCATE

The Master’s prepared nurse as consumer advocate brings expert knowledge and experience to the role, “because they are prepared as patient caregivers, know about patient care management, and understand the nuances,” says Irene Zbiczak, RN, MHSL, PRC, 2005 president of the Society for Healthcare Consumer Advocacy (SHCA), a national health care consumer advocacy organization.(Geoghegan, 2006, para. 6)

Consumers are ignorant about the healthcare system and that puts them at risk. Patients need to know their options and what they can expect from their various choices. Nurses are always being asked for advise on Health care, which doctor to see, what brand of an over the counter medication to buy, as educated professional their opinion is respected.

MANAGER OF SYSTEMS

The Master’s prepared nurse as manager of systems plays an essential role in healthcare. The manager is the backbone of the organization.(“Management,” n.d). The quality of patient care is her responsibility. Staffing is a major factor every day and dealing with staffing issues and shortages. Staff recruitment and retention success are integral. Every day she is juggling many challenges; productivity, the budget, dealing with multiple departments and disciplines; managing up, down, and across; in addition to finding time to provide excellent care for patients. (“Management,” n.d).

CONSULATANT

The consultant role is a clinical specialist requiring comprehensive specialized health and medical care knowledge. Consultants review and suggest changes in nursing organization and administrative procedures. They analyze nursing practices and recommend change. As experienced and educated nurses the MSN is often called upon for her knowledge of a particular situation or piece of equipment. This role can be as basic as working in the hospital and as complex as working as a legal expert.

CHANGE AGENT

The Master’s prepared nurse can influence change by raising their voices and speaking out about issues, concerns or injustices in the organization. Evidence based practice is now the norm in nursing, when a nurse sees an old practice being carried out, she can present the evidence and amend a policy or procedure to reflect the evidence.

MSNs can influence change through the various career paths they take. According to NurseSource.org, by pursuing innovative, non-traditional ways to practice nursing, these nurses “can now be found in professional venues once thought impossible.” (Dyches, n.d, para. 3) Nursing can lead to career opportunities in fields such as education, law, business, and journalism and in all these field the nurse can be affect change.

IMPROVING HEALTHCARE DELIVERY and OUTCOMES

The 2010 healthcare reform act (Patient Protection and Affordable Care Act, or PPACA) gives nurses new opportunities to deliver care and play an integral role in leading change. (Hassmiller, 2010). Nurses know how to expand access to care and improve quality at lower cost. By emphasizing the use of master’s-prepared nurses to oversee care from the hospital to within the home, the Transitional Care Model has reduced rehospitalizations for elderly patients with multiple chronic conditions. (Hassmiller, 2010).

Master’s prepared nurses provide evidence and engage in research to improve their own practice in an effort to improve care. The Robert Wood Johnson Foundation supports nurse researchers by funding the Interdisciplinary Nursing Quality Research Initiative, a program that links evidenced-based nursing care to improved patient outcomes.(Naylor, Pauly, & Melichar, n.d)

Advanced practice nurses are working with physicians to provide cost-effective care and help address the primary care shortage. Master’s prepared nurses embrace technology using use the new­est medical technology and electronic documentation systems to improve quality.

EFFECTIVE COMMUNICATION STRATERGIES

When health care professionals are not communicating effectively, patient safety is at risk. Effective communication strategies can be as basic as listening and as broad as using standardized communication tools like SBAR or the WHO Safe Surgery checklist, to ensure that the correct message is always portrayed.

Here are some good basic strategies: Find out what they really mean by asking. Always start by explaining yourself and why you don’t understand, rather than slamming them for what they said. Really listen and stay focused on what the other persons message is, and resist distractions while they are speaking. Show them that they and their message are important to you. Don’t start thinking of what you are going to say while the other person is talking. Also keep an open mind to others’ ideas even if you disagree. Paraphrase what you heard to ensure you are talking about the same thing.

COLLABORATIVE AND INTERDEPENDENT RELATIONSHIPS

Collaborative relationships are when two or more people come together to work together to realize the shared goals. Interdependent relationship means the dependency of one thing to others. Collaboration involves both relationship building and shared decision making. When people don’t agree with a situation, you can agree to disagree is a form of collaboration.

In order to foster good relationships trust needs to be built, distrust

NEGOTIATION SKILLS Negotiating involves individuals developing self-awareness around differences in communication styles and skills to confer with health professionals from other disciplines, value others’ perspectives and opinions and manage conflict if the situation arises Maintain attentiveness to personal and professional values.

Articulate and consistently follow a morally-derived hierarchy of obligation. Determine the nature of the problem. Choose alternative solutions thoughtfully.

Some strategies include focusing on the parities needs/interests, ensure confidentiality, being cost effective, decreasing time and stress, and maintaining and building relationships

It is a distinct process utilized in negotiation practices among professionals..

MASTERS PREPARED ROLES:

NURSE PRACTIONER

Nurse practitioners are expert clinicians who provide primary, acute and specialty healthcare to patients of all ages and walks of life. (“APRN,” 2008)

They are the healthcare providers of choice for millions of patients. NPs assess patients, order and interpret diagnostic tests, make diagnoses, and initiate and manage treatment plans – including prescribing medications. They educate and counsel patients and their families regarding healthy lifestyles and health care options . In 25 states, NPs have authority to practice independently

CLINICAL NURSE SPECIALIST

A clinical nurse specialist (CNS) is an advanced practice nurse whose care focuses on a specific patient population or setting. A CNS can specialize in certain types of diseases, such as diabetes or cardiovascular disease, can work in many different medical environments (such as an operating room, emergency room or critical care), and can focus on a variety of procedures (such as surgical or clinical). Clinical Nurse Specialists provide direct patient care

Five general duties make up a clinical nurse specialist’s daily routine: Clinical practice, teaching, research, consulting and management.

Clinical Nurse Specialists focus on one of three main specialty areas: patients and their families, nurse management, and administration.

NURSE ANESTHETIST

CRNAs provide anesthetics to patients in collaboration with surgeons, anesthesiologists, dentists, podiatrists, and other qualified healthcare professionals. They administer every type of anesthetic, work in every type of practice setting, and provide care for every type of operation or procedure – from open heart surgery to pain management programs. As Advanced Practice nurses, they are given a high degree of autonomy and professional respect. CRNAs carry a heavy load of responsibility and are compensated accordingly.

CERTIFIED NURSE-MIDWIFE

Certified Nurse- provide counseling and care during preconception, pregnancy, childbirth, and the post-partum period. CNMs also provide family-centered primary healthcare and routine gynecological services to women throughout their reproductive lives .CNMs are skilled health professionals who practice in a wide variety of clinical settings from homes to hospitals and office practises, diagnosing and treating patients as well as referring them to a specialist, if required. They work under the guidance of an OBGYN.